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Author (up) Ajami, N.J.; Kavanagh, O.V.; Ramani, S.; Crawford, S.E.; Atmar, R.L.; Jiang, Z.-D.; Okhuysen, P.C.; Estes, M.K.; DuPont, H.L. doi  openurl
  Title Seroepidemiology of norovirus-associated travelers' diarrhea Type Research Support, U.S. Gov't, Non-P.H.S.
  Year 2014 Publication Journal of travel medicine Abbreviated Journal J Travel Med  
  Volume 21 Issue 1 Pages 6-11  
  Corporate Author Thesis  
  Address Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, USA; School of Public Health, Center for Infectious Diseases, Houston, TX, USA  
  Keywords Adult; *Diarrhea/blood/epidemiology/physiopathology/virology; Disease Outbreaks; Feces/virology; Female; Gastroenteritis/blood/epidemiology/physiopathology/virology; Humans; Immunoassay/methods; Immunoglobulins/blood; Male; Mexico/epidemiology; Norovirus/*isolation & purification; Outcome Assessment (Health Care); Reverse Transcriptase Polymerase Chain Reaction/methods; Seroepidemiologic Studies; Serologic Tests/methods; *Travel; United States/epidemiology  
  Abstract BACKGROUND: Noroviruses (NoVs) are the most common cause of epidemic gastroenteritis, responsible for at least 50% of all gastroenteritis outbreaks worldwide and were recently identified as a leading cause of travelers' diarrhea (TD) in US and European travelers to Mexico, Guatemala, and India. METHODS: Serum and diarrheic stool samples were collected from 75 US student travelers to Cuernavaca, Mexico, who developed TD. NoV RNA was detected in acute diarrheic stool samples using reverse transcription-polymerase chain reaction (RT-PCR). Serology assays were performed using GI.1 Norwalk virus (NV) and GII.4 Houston virus (HOV) virus-like particles (VLPs) to measure serum levels of immunoglobulin A (IgA) and IgG by dissociation-enhanced lanthanide fluorescent immunoassay (DELFIA); serum IgM was measured by capture enzyme-linked immunosorbent assay (ELISA), and the 50% antibody-blocking titer (BT50 ) was determined by a carbohydrate-blocking assay. RESULTS: NoV infection was identified in 12 (16%; 9 GI-NoV and 3 GII-NoV) of 75 travelers by either RT-PCR or fourfold or more rise in antibody titer. Significantly more individuals had detectable preexisting IgA antibodies against HOV (62/75, 83%) than against NV (49/75, 65%) (p = 0.025) VLPs. A significant difference was observed between NV- and HOV-specific preexisting IgA antibody levels (p = 0.0037), IgG (p = 0.003), and BT50 (p = <0.0001). None of the NoV-infected TD travelers had BT50 > 200, a level that has been described previously as a possible correlate of protection. CONCLUSIONS: We found that GI-NoVs are commonly associated with TD cases identified in US adults traveling to Mexico, and seroprevalence rates and geometric mean antibody levels to a GI-NoV were lower than to a GII-NoV strain.  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 1195-1982 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:24383649 Approved no  
  Call Number NCSU @ edshirle @ Serial 3082  
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